The effect of COVID-19 on the high number of immunocompromised people living with HIV-1 (PLWH), particularly in Africa, remains a critical concern. Here, we identify key areas that still require further investigation, by examining COVID-19 vaccine effectiveness, and understanding antibody responses in SARS-CoV-2 infection and vaccination in comparison with people without HIV-1 (PWOH). We also assess the potential impact of pre-existing immunity against endemic human coronaviruses on SARS-CoV-2 responses in these individuals. Lastly, we discuss the consequences of persistent infection in PLWH (or other immunocompromised individuals), including prolonged shedding, increased viral diversity within the host, and the implications on SARS-CoV-2 evolution in Africa.
Keywords: COVID-19; Fc effector function; SARS-CoV-2 infection; SARS-CoV-2 vaccination; humoral immunity; immunocompromised; intrahost diversity; neutralization; people living with HIV-1; persistent infection; prolonged SARS-CoV-2 shedding; variants of concern; viral evolution.
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